Cost Associated With Pediatric Delirium in the ICU

Chani Traube, Elizabeth A Mauer, Linda M Gerber, Savneet Kaur, Christine Joyce, Abigail Kerson, Charlene Carlo, Daniel Notterman, Stefan Worgall, Gabrielle Silver, Bruce M Greenwald, Chani Traube, Elizabeth A Mauer, Linda M Gerber, Savneet Kaur, Christine Joyce, Abigail Kerson, Charlene Carlo, Daniel Notterman, Stefan Worgall, Gabrielle Silver, Bruce M Greenwald

Abstract

Objective: To determine the costs associated with delirium in critically ill children.

Design: Prospective observational study.

Setting: An urban, academic, tertiary-care PICU in New York city.

Patients: Four-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014.

Interventions: None.

Measurements and main results: All children were assessed for delirium daily throughout their PICU stay. Hospital costs were analyzed using cost-to-charge ratios, in 2014 dollars. Median total PICU costs were higher in patients with delirium than in patients who were never delirious ($18,832 vs $4,803; p < 0.0001). Costs increased incrementally with number of days spent delirious (median cost of $9,173 for 1 d with delirium, $19,682 for 2-3 d with delirium, and $75,833 for > 3 d with delirium; p < 0.0001); this remained highly significant even after adjusting for PICU length of stay (p < 0.0001). After controlling for age, gender, severity of illness, and PICU length of stay, delirium was associated with an 85% increase in PICU costs (p < 0.0001).

Conclusions: Pediatric delirium is associated with a major increase in PICU costs. Further research directed at prevention and treatment of pediatric delirium is essential to improve outcomes in this population and could lead to substantial healthcare savings.

Figures

Figure 1
Figure 1
Total PICU cost: never vs. ever delirious Costs of PICU care, reported as median cost in 2014 US dollars, were higher in the ever delirious group (p

Figure 2

Cost per day: never vs.…

Figure 2

Cost per day: never vs. ever delirious Costs per day (total PICU cost…

Figure 2
Cost per day: never vs. ever delirious Costs per day (total PICU cost divided by PICU LOS), reported as median cost in 2014 US dollars, were higher in the ever delirious group (p

Figure 3

Total PICU cost by number…

Figure 3

Total PICU cost by number of days delirious Total costs, reported as median…

Figure 3
Total PICU cost by number of days delirious Total costs, reported as median cost in 2014 US dollars, were significantly different across delirium severity groups (p
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Figure 2
Figure 2
Cost per day: never vs. ever delirious Costs per day (total PICU cost divided by PICU LOS), reported as median cost in 2014 US dollars, were higher in the ever delirious group (p

Figure 3

Total PICU cost by number…

Figure 3

Total PICU cost by number of days delirious Total costs, reported as median…

Figure 3
Total PICU cost by number of days delirious Total costs, reported as median cost in 2014 US dollars, were significantly different across delirium severity groups (p
Similar articles
Cited by
MeSH terms
Related information
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 3
Figure 3
Total PICU cost by number of days delirious Total costs, reported as median cost in 2014 US dollars, were significantly different across delirium severity groups (p

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